By releasing the complete medical report of former Chief Minister J Jayalalithaa, the Tamil Nadu government seemingly wants to make it clear that there is no mystery behind her death and that she had received the best treatment possible in India. The report also refutes the allegation that she had suffered trauma, by being pushed down, at her Poes Garden residence.
The report, put together by the medical team at the Apollo Hospitals and the team of specialists from the All India Institute Medical Sciences (AIIMS) that visited her thrice during her hospital stay, certainly shows that she was critically ill at the time of admission, had multiple medical issues, and was given the most appropriate treatment through a consultative process. Even international experts, including from Johns Hopkins Hospital, were consulted and there was no disagreement on the line of treatment provided by the medical team.
The compulsion of the ruling AIADMK and the government to release the medical reports in full appears to have stemmed from the allegations of the dissident faction led by O Panneerselvam (OPS) that has demanded a probe into Jaya's death. OPS has been able to generate some suspicion in the public mind, particularly because of the inconsistent medical bulletins and lack of transparency so far. He has announced a fast from 8 March and the government obviously wants to take the wind out of his sails. His complaint, which incidentally is also a potent political tool, is about what happened "during the 75 days" of treatment at the hospital; by making the records public, the government has sufficiently answered him.
How did the Chief Minister of a state reach such a critical condition before she was admitted? Had she been given wrong treatment as some media reports suggested?
However, the critical question that he or his faction should have asked is not about what happened at the hospital because it has been documented and couldn't have been tinkered with owing to the involvement of the AIIMS team, but what happened prior to Jaya's hospitalisation. How did the Chief Minister of a state reach such a critical condition before she was admitted? Had she been given wrong treatment as some media reports suggested?
The press release of the government issued along with the medical report, does seek to answer this suspicion as well, but only partially.
"Certain insinuations have been made that administration of wrong drugs over a period of time prior to hospitalization had led to health complications for the late Honorable Chief Minister. In this context, the medical reports indicate that except for corticosteroids administered for atopic dermatitis, the late Hon'ble Chief Minister was only taking oral hypoglycemic and anti-hypertensive drugs to control pre-existing diabetes mellitus and hyper tension."
In fact, it opens up more questions than it answers.
According to the medical report, Jaya didn't suffer from any major ailment other than the common lifestyle-diseases such as diabetes, hypertension, and chronic conditions such as hypothyroidism and asthmatic bronchitis. She also had irritate bowel syndrome and topical dermatitis for which a tapering course of steroids was prescribed. Do these conditions suddenly lead to a critical situation that she was in when Apollo Hospitals was asked to help?
According to the medical report, at the time of admission, Jaya wasn't consistently responding to verbal commands (in layman's language, not fully conscious) and was breathless with very low oxygen saturation in her blood. The examination at the hospital also showed pulmonary oedema (fluid collection around the lungs) and inconsistent heart function. Her blood sugar was 560, which was excessively high even for a badly managed diabetes patient. She also had a urinary tract infection, for which she had been given both antibacterial and anti fungal medications, and intermittent fever.
How did Jaya plunge into a life-threatening situation before admission to the hospital that further worsened to her eventual death? The medical reports do not suggest any other pre-existing conditions that could have caused this distress. The only other possibility is inappropriate treatment for her existing medical conditions, and failure to diagnose some other illness.
How did Jaya plunge into a life-threatening situation before admission to the hospital that further worsened to her eventual death?
The collection of fluids around her lungs could have been caused by many medical conditions including a congestive heart failure. Did she have one that was undiagnosed? Or were there any underlying medical conditions, such as an auto immune disease, that could have caused it? It's not something that the medical report of Apollo or AIIMS ought to answer, but the doctors who had been treating her all these years. How did they miss something that led to her oedema and respiratory distress? Why wasn't her diabetes under control?
It's hard to point fingers at somebody if the treatment Jaya had been receiving at home were insufficient because she herself could have taken it easy despite the best medical advice. Probably the political climate in the state made her secretive and circumspect in openly seeking treatment. Had the best medical treatment been availed, probably she wouldn't have reached such a critical stage because her pre-existing conditions, as have been publicly stated now, were not alarming at all. Can the Apollo-AIIMS medical team throw some light on this because there lies the answer to the allegations about her death.
What's obviously certain is that both the medical bulletins and people close to Jaya were not forthcoming during her hospital stay, probably for political reasons.
The government press release also said that "the treatment report of Apollo Hospital, as well as that of AIIMS do not mention any evidence of trauma or any other event as alleged by certain political leaders." This is clearly in response to the allegations of PH Pandian, a veteran AIADMK leader and former assembly speaker who is now in the OPS camp, who said that prior to her hospitalisation, Jaya was pushed down at her Poes Garden residence. "Amma (Jayalalithaa) fell down after someone pushed her. Nobody knows what happened to Amma after that. A police official called an ambulance, and she was taken to hospital." was his allegation.
What's obviously certain is that both the medical bulletins and people close to Jaya were not forthcoming during her hospital stay, probably for political reasons. The medical bulletins were sketchy and not consistent with the final report that has been released now. More over, the final report doesn't state a situation in which she could have discussed official matters and offered her finger-print. According to the press release, while in the hospital, Jaya "interacted with family and Government officials on some important issues including the Cauvery issue." This claim too should be ratified by the Apollo-AIIMS team to make matters completely trustworthy.